Morphologic and Confocal Investigation on Salzmann Nodular Degeneration of the Cornea

Roszkowska, Anna M.; Aragona, Pasquale; Spinella, Rosaria; Pisani, Antonina; Puzzolo, Domenico; Micali, Antonio

doi:10.1167/iovs.11-7789

Cited by 27 publications

(24 citation statements)

References 28 publications

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“…23 They attributed these changes to dry eye and subbasal nerve loss. More recently, Roszkowska et al 32 showed severe superficial epithelial changes by IVCM in Salzmann nodular degeneration of the cornea by IVCM. They observed enlarged squamous cells with prominent nuclei and bright margins in the superficial layer of the central corneal epithelium.…”

Section: Discussionmentioning

confidence: 98%

Cellular Changes of the Corneal Epithelium and Stroma in Herpes Simplex Keratitis

et al. 2012

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Purpose To analyze the morphology of corneal epithelial cells and keratocytes by in vivo confocal microscopy (IVCM) in patients with herpes simplex keratitis (HSK) as associated with corneal innervation. Design Prospective, cross-sectional, controlled, single-center study. Participants Thirty-one eyes with the diagnosis HSK and their contralateral clinically unaffected eyes were studied and compared with normal controls (n = 15). Methods In vivo confocal microscopy (Confoscan 4; Nidek Technologies, Gamagori, Japan) and corneal esthesiometry (Cochet-Bonnet; Luneau Ophthalmologie, Chartres, France) of the central cornea were performed bilaterally in all patients and controls. Patients were grouped into normal (>5.5 cm), mild (>2.5–5.5 cm), and severe (<2.5 cm) loss of sensation. Main Outcome Measures Changes in morphology and density of the superficial and basal epithelial cells, as well as stromal keratocytes were assessed by two masked observers. Changes were correlated to corneal sensation, number of nerves, and total length of nerves. Results There was a significant and gradual decrease in the density of superficial epithelial cells in HSK eyes, with 852.50±24.4 cells/mm2 in eyes with severe sensation loss and 2435.23±224.3 cells/mm2 in control eyes (p=0.008). Superficial epithelial cell size was 2.5-fold larger in HSK eyes (835.3 μm2) as compared to contralateral or normal eyes (407.4 μm2; p= 0.003). A significant number of hyperreflective desquamating superficial epithelial cells were present in HSK eyes with normal (6.4%), mild (29.1%) and severe (52.2%) loss of sensation, but were absent in controls. The density of basal epithelial cells, anterior keratocytes, and posterior keratocytes did not show statistical significance between patients and controls. Changes in superficial epithelial cell density and morphology correlated strongly with total nerve length, number, and corneal sensation. Scans of contralateral eyes did not show any significant epithelial or stromal changes as compared to controls. Conclusions IVCM reveals profound HSK-induced changes in the superficial epithelium, as demonstrated by increase in cell size, decrease in cell density, and squamous metaplasia. We demonstrate that these changes strongly correlate with changes in corneal innervation.

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Section: Discussionmentioning

confidence: 98%

Cellular Changes of the Corneal Epithelium and Stroma in Herpes Simplex Keratitis

et al. 2012

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“…228 Likewise, analysis by IVCM of cases with Terrien’s marginal corneal degeneration have found a decrease in the subbasal nerve density and branching. 229 …”

Section: Correlation Of Corneal Nerve Alterations To Corneal Sensmentioning

confidence: 98%

In Vivo Confocal Microscopy of Corneal Nerves in Health and Disease

2017

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In vivo confocal microscopy (IVCM) is becoming an indispensable tool for studying corneal physiology and disease. Enabling the dissection of corneal architecture at a cellular level, this technique offers fast and noninvasive in vivo imaging of the cornea with images comparable to that of ex vivo histochemical techniques. Corneal nerves bear substantial relevance to clinicians and scientists alike, given their pivotal roles in regulation of corneal sensation, maintenance of epithelial integrity, and proliferation and promotion of wound healing. Thus, IVCM offers a unique method to study corneal nerve alterations in a myriad of conditions, such as ocular and systemic diseases and following corneal surgery, without altering the tissue microenvironment. Of particular interest has been the correlation of corneal subbasal nerves to their function, which has been studied in normal eyes, contact lens wearers, and patients with keratoconus, infectious keratitis, corneal dystrophies, and neurotrophic keratopathy. Longitudinal studies have applied IVCM to investigate the effects of corneal surgery on nerves, demonstrating their regenerative capacity. IVCM is increasingly important in the diagnosis and management of systemic conditions such as peripheral diabetic neuropathy and, more recently, in ocular diseases. In this review, we outline the principles and applications of IVCM in the study of corneal nerves in various ocular and systemic diseases.

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“…The nerve fibre appears as an undulating sloping line with high intensity. Moreover, there is a presence of reflective cellular elements near these fibres 27 28. SSCM (Confoscan 2) was used to capture the images of Salzmann's nodular degeneration.…”

Section: Corneal Layers In Diseasementioning

confidence: 99%

In vivo confocal microscopic corneal images in health and disease with an emphasis on extracting features and visual signatures for corneal diseases: a review study

et al. 2015

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There is an evolution in the demands of modern ophthalmology from descriptive findings to assessment of cellular level changes by using in vivo confocal microscopy. Confocal microscopy, by producing grey-scale images, enables a microstructural insight into the in vivo cornea in both health and disease, including epithelial changes, stromal degenerative or dystrophic diseases, endothelial pathologies, and corneal deposits and infections. Ophthalmologists use acquired confocal corneal images to identify health and disease states and then to diagnose which type of disease is affecting the cornea. This paper presents the main features of the healthy confocal corneal layers, and reviews the most common corneal diseases. It identifies the visual signature of each disease in the affected layer and extracts the main features of this disease in terms of intensity, certain regular shapes with both their size and diffusion, and some specific region of interest. These features will lead towards the development of a complete automatic corneal diagnostic system which predicts abnormalities in the confocal corneal data sets.

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Morphologic and Confocal Investigation on Salzmann Nodular Degeneration of the Cornea

Cited by 27 publications

References 28 publications

Cellular Changes of the Corneal Epithelium and Stroma in Herpes Simplex Keratitis

Cellular Changes of the Corneal Epithelium and Stroma in Herpes Simplex Keratitis

In Vivo Confocal Microscopy of Corneal Nerves in Health and Disease

In vivo confocal microscopic corneal images in health and disease with an emphasis on extracting features and visual signatures for corneal diseases: a review study

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